Travel

Seva Canada: Giving the gift of sight

I love sharing travel tales, particularly the funny ones. (Like that night I spent in Nepal last spring bunking with a goat.) But other stories are harder to tell.

On that same trip to Nepal, in a little town called Martadi in the impoverished Bajura District, I witnessed a miracle. Several, in fact. And I don't have a ready vernacular for miracles. Granted, I grew up in a religious culture, immersed in tales of a man walking on water, virgin births and resurrection from the dead. We grew up praying for big miracles (instant cures for terminal illness), and small, selfish ones (winning the lotto) – but we never expected miracles to happen right in front of us. My trip with Seva Canada, an organization dedicated to curing blindness, upended all that. When I saw the first miracle happen, I felt uneasy, for no other reason than that I wasn't used to it. And then I saw it a second time, and 62 more times after that. Now I believe.

The journey to Bajura At the break of dawn, I stood outside my tent on top of a cliff on the edge of Martadi. The vista was Pinterest-worthy: A patchwork of terraced wheat fields, jagged cliffs, and foot bridges spanning fast-flowing rivers. Farmers toiled away in their fields before the sun became too brutal. A long line of mules zig-zagged slowly up a dirt path, their tinkling bells providing the morning's Muzak. I was very conscious of how beautiful the scene was – and that it was one not every Nepali could share. Blindness robs people of these everyday pleasures.

The journey here was one of the hardest I'd ever experienced: a dizzying day-long bus ride (forget shock absorbers and A/C) up a 1,000-metre precipice with no guard rails, a crazy jeep ride on switchback mountain routes and a 20-kilometre hike in blistering heat. Steep, almost 90-degree climbs sucked the wind out of me. But this is a journey people living in the Bajura region make routinely and the Seva team made it without complaint.It is also a journey made by the hopeful blind, who come here for the eye camp.

Seva is a Vancouver-based organization that brings eye care to people in need; along with the many eye-care centres it has helped establish in urban areas throughout the world (in Africa and Asia, mostly), it organizes free eye camps in remote, rural areas like Martadi. "The inauguration of the Primary Eye Care Centre in Bajura, the last district in all of Nepal without access to eye care, is a major milestone," says Penny Lyons, Seva Canada's executive director. "After 30 years, we can now provide access to eye care and hope to every Nepali." In a country besieged by blindness, this day has been long in the coming.

Nepal: home to the poorest of the poor Sixteen percent of Nepal's 21 million people suffer from one or more eye diseases, and three percent are totally or partially blind. There are many causes, including glaucoma and infectious diseases such as trachoma, but the leading cause is cataracts. "The greatest tragedy of all," says Dr. Ken Bassett, program director of Seva Canada and a professor of medicine at the University of British Columbia, "is that most eye diseases afflicting Nepalis are preventable and ultimately curable. For cataracts, all it takes is a 15-minute surgery." Eye infections, he adds, can be treated for $2.50. According to the World Health Organization, restoring eyesight is one of the most cost-effective ways of reducing poverty. So why aren't more Nepalis being treated?

Nepal remains one of the least developed countries in the world, and many of its poor cannot afford treatment fees. "One of the saddest things is the lack of money," says Dr. Bidya Prasad Pant, director of the Seva-funded Geta Eye Hospital in Dhangadhi. "I recall an incident that happened when I was visiting a hospital not supported by Seva. While the surgeries were subsidized, the patient had to pay a small sum. One woman did not have the 500 rupees (roughly $8) she needed. Sadly, she was turned away. At the end of the day, a crowd had convened at the edge of the river. We learned that the woman had thrown herself from the ferry. Instead of returning home and continuing to be a burden to her family, she decided that suicide was the better option."

Helping women get eye care For women and girls with blindness, there's an added obstacle: their gender. "Most communities are patriarchal," explains Dr. Pant, "and the men will come to an eye camp and have their cataracts removed, then the boys, and then, but not always, the women and girls. Sadly, in many cases, as is seen in other parts of the world, more value is placed on the male members of the family." Seva tries to help by holding multiple camps. "Going back to the same place repeatedly is a proven strategy for increasing the proportion of women who receive care," says Dr. Bassett.

During my visit, I met Ina Sunar, a determined 50-year-old from the tiny village of Pandusen who suffers from bilateral cataracts. She travelled for three days (carried on the back of her son Suryabahdur) to get there. She was shy about talking to me, but explained (via an interpretor) that her neighbours had encouraged her to come, and that she hadn't seen her family clearly in nearly five years. Her wish wasn't just to regain her eyesight. "I don't like being dependent on other people," she explained, haltingly. Exasperation crept momentarily into her voice. "I don't want to spend all day lying in bed. I'm not doing my share of work. My granddaughter stays with me all the time, so she's not working. She's at the age where she should be getting out more. And my son is past the marrying age. He should have children. But he doesn't go out of the house because of me."

Changing the fate of Nepali women Ram Prasad Kandel has been Seva's program director in Nepal for the last 15 years. His father, a Hindu priest, was an ayurvedic medical practitioner, so Kandel's desire to heal comes naturally. As he sees it, some of the biggest obstacles to improving eye care in Nepal are cultural ones. "In many communities, if a young girl or woman is blind, the family will send her to a traditional faith healer. If that doesn't work, perhaps they'll make an offering of rice to the gods. Or, as I've seen many times, the head of the household will decide it's up to fate: ‘Oh well, she's got one good eye, let us be thankful for that.'"

According to Lyons, one of the more common phrases she hears during her many trips to Nepal is: "One eye for me, one for the gods." Sometimes a woman will have one cataract removed, then head home without having the second cataract removed the next day. "I can't outwardly challenge that because that is part of their belief system," says Lyons. "We can't foist our Western values on people." Instead, Seva simply makes sure people know that the second surgery is available. Every success is an example. Villagers leave home blind in both eyes, then return a few days later with eyesight fully restored. Word travels. How Seva Canada helps Seva is a Sanskrit word meaning "service to others," and members of the organization take that definition quite literally. Dr. Pant, for instance, sometimes performs 300 cataract surgeries per day. During this particular eye camp, he and his team examined 756 Nepalis and performed 64 cataract surgeries.

Partnerships with local health authorities are key to Seva's work. "We're not a charitable organization, we're an international development organization," explains Lyons, who took a 50 percent pay cut when she left the corporate world for Seva. "People like Ina are my bosses; I'm in service to them." Seva also trains Nepalis to treat vision problems and perform cataract surgeries. So if Seva were ever to disappear, the vision-care work would continue.

I followed Ina throughout her stay at the camp: through the initial screening, the testing, the interviews, the filling out of forms. I asked her questions, and listened as her responses became more energized. "What are the first things you want to see once you're able to see again?" I asked. She spoke, smiled, and the translator broke up laughing. "I am eager to see my granddaughter again. She was pretty when I last saw her, but who knows, maybe she's no longer pretty." Then, after a pause, came her real answer: "I want to get back to work. I want to tend to my ox in the fields. I want to see the river near my home. I want to cook. I want to take care of my home and family."

The big reveal The atmosphere was electric on the final day of eye camp, when bandages were removed. Unspoken questions hung like clouds in the air: "Did the operation work? Is my blindness gone?"

Three rows of men, women and children squatted on parched grass next to a barn-like building where the cataract surgeries are performed. There was no pomp or ceremony. One by one, the patients tilted their heads back and allowed Dr. Pant to gently remove their bandages. A nurse swabbed their eyes, then escorted each patient to a chair to look at an optical chart six metres away. Dr. Pant looked into Ina's eyes, then raised a finger. "How many?" One. "How many now?" Four. "The sky, is it blue?" Yes. "The grass, is it green?" Yes. "My skin, what is the colour?" Brown.

I didn't stay for the full test. Tears pooled in my eyes and I had a lump the size of a golf ball in my throat. I had no words for what I was seeing. Ina's smile. Her amazement as she looked at the loving granddaughter who was so changed since she last saw her.

And so it continued. Bandage after bandage removed. One person after another, joyous, thankful, in shock. I didn't understand a word anyone said, except for the recurring "Namaste, Namaste": Thank you. Thank you. I stood there, watching men and women see for the first time in years, watching them smile at the sight of loved ones. What I saw was a miracle.

How you can help A cataract operation (a $50 donation) doesn't just restore a person's eyesight, it restores their dignity, enables them to work and care for their children and be an active part of their community. Learn more at seva.ca.